SAFETY CHECKLIST FOR SURGERY

It has been estimated that 234 million surgeries are performed (globally) every year. Unfortunately, preventable surgical complications are way too common for those procedures.

A report published by the New England Journal of Medicine (NEJM), found the death rate from preventable surgical complications to be 1.5 patients out of every 100. The non-fatal, inpatient surgical complication rate is about 11 patients for every 100. What happens when a simply safety checklist is used? The death rate dropped almost in half to .8 patients out of every 100. The non-fatal complication rate dropped to 7 patients out of every 100. Pretty significant don’t you think! Here are the elements of the Surgical Safety Checklist:

BEFORE INDUCTION OF ANESTHESIA:

Members of the team (at least the nurse and an anesthesia professional) orally confirm that:
The patient has verified his or her identity, the surgical site and procedure, and consent.
The surgical site is marked or site marking is not applicable.
The pulse oximeter is on the patient and functioning.
All members of the team are aware of whether the patient has a known allergy.
The patient’s airway and risk of aspiration have been evaluated and appropriate equipment and assistance are available.
If there is a risk of blood loss of at least 500 ml (or 7 ml/kg of body weight, in children), appropriate access and fluids are available.

BEFORE SKIN INCISION:

The entire team (nurses, surgeons, anesthesia professionals, and any others participating in the care of the patient) orally:
Confirms that all team members have been introduced by name and role.
Confirms the patient’s identity, surgical site, and procedure.
Reviews the anticipated critical events.
Surgeon reviews critical and unexpected steps, operative duration, and anticipated blood loss.
Anesthesia staff review concerns specific to the patient.
Nursing staff review confirmation of sterility, equipment availability, and other concerns.
Confirms that prophylactic antibiotics have been administered ≤0 min before incision is made or that antibiotics are not indicated.
Confirms that all essential imaging results for the correct patient are displayed in the operating room.

BEFORE PATIENT LEAVE THE OPERATING ROOM:

Nurse reviews items aloud with the team.
Name of the procedure as recorded.
That the needle, sponge, and instrument counts are complete (or not applicable).
That the specimen (if any) is correctly labeled, including with the patient’s name.
Whether there are any issues with equipment to be addressed.
The surgeon, nurse, and anesthesia professional review aloud the key concerns for the recovery and care of the patient.

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Dan Frith

Dan Frith has over 25 years of experience representing individuals and families in cases of medical malpractice throughout Virginia. He has been named "Best Medical Malpractice Attorney" by Roanoker Magazine and is a member of the Million Dollar Advocates Forum. To speak with Dan, contact him by email at dfrith@frithlawfirm.com.